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对疑似患有心肌病患者的心内膜心肌活检进行批判性分析。II:组织学与临床/血流动力学信息的比较。

Critical analysis of endomyocardial biopsies from patients suspected of having cardiomyopathy. II: Comparison of histology and clinical/haemodynamic information.

作者信息

Baandrup U, Florio R A, Rehahn M, Richardson P J, Olsen E G

出版信息

Br Heart J. 1981 May;45(5):487-93. doi: 10.1136/hrt.45.5.487.

Abstract

Endomyocardial biopsies showing histological evidence of "ordinary" hypertrophy or changes compatible with congestive cardiomyopathy (COCM) were obtained from 125 patients. Statistical analysis compared histological/morphometric data with clinical/haemodynamic findings such as ejection fraction, left ventricular end-diastolic pressure, and length of history. Patients were grouped either according to the histological description or the clinical diagnosis. Comparison of the morphological description with the final clinical diagnosis was also undertaken. Follow-up of the patients was between two and 66 months. The results of the statistical analyses showed no correlation between quantitative, morphological assessment and either clinical information, that is length of history and subsequent course, or the haemodynamic variables. In 86 per cent of cases a rough agreement between the morphological description and the clinical diagnosis was obtained, but no specific pattern permitting a morphological diagnosis of COCM was established. The findings suggest that pronounced topographic variation in biopsy material exists and that, therefore, the severity of COCM or its prognosis cannot be assessed from histological changes.

摘要

从125例患者获取了心内膜心肌活检组织,这些活检组织显示出“普通”肥厚的组织学证据或与充血性心肌病(COCM)相符的改变。统计分析将组织学/形态学数据与诸如射血分数、左心室舒张末期压力和病程等临床/血流动力学结果进行了比较。患者要么根据组织学描述分组,要么根据临床诊断分组。还对形态学描述与最终临床诊断进行了比较。患者的随访时间为2至66个月。统计分析结果显示,定量形态学评估与临床信息(即病程和后续病程)或血流动力学变量之间均无相关性。在86%的病例中,形态学描述与临床诊断大致相符,但未确立允许对COCM进行形态学诊断的特定模式。这些发现表明活检材料存在明显的局部差异,因此,无法根据组织学改变评估COCM的严重程度或其预后。

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